Yasmine’s guest today, is Heather Hall:
Heather has a wide range of expertise in the field. She has a Graduate degree in global public health nursing, previously worked as a nurse in Kenya, did consulting public health work in Kenya and a few other African countries, is a former Program Coordinator for the Tuberculosis/Refugee/Immigration Programs at a health department in Ohio, and recently did COVID-19 policy work for a local health department in Oregon.
Yaz and Heather discuss the definition of Global Health, the Sustainable Development Goals and their relationship to Health, and dispel the three main misconceptions about global health.
What is Global Health
Season 1, Episode 3
Release Date: July 39, 2022
00:00:00 Yasmine Vaughan - Yasmine Vaughan
Second, welcome to HCW Optimistic Voices podcast.
00:00:10 Yasmine Vaughan
I'm your host, Yasmin Vaughn.
00:00:12 Yasmine Vaughan
Today's episode is all about global health.
I'm here with Heather Hall, a global public health nurse.
Heather thanks for joining us.
00:00:20 Heather Hall
Yeah, thanks so much.
00:00:20 Heather Hall
For having me.
In order to talk about what is global health, we think.
It would be useful to.
First, define global health and when it comes to the field.
Of global health
I think most.
Of the people who don't work in this discipline, believe that global health is about transnational issues like pandemic control, emerging infectious diseases, diseases.
That had the potential to cross borders.
Those sorts of things.
00:00:45 Yasmine Vaughan
If I could.
00:00:46 Heather Hall
Kind of maybe summarize.
00:00:47 Heather Hall
I would maybe break it down, but there are three main misconceptions about global health that people tend to have.
00:00:55 Heather Hall
First of all, I think people often have an US versus them mentality.
00:01:00 Heather Hall
And with the, with the mindset that you know global health and global health issues, that's something that happens to.
00:01:06 Heather Hall
Those people over there.
00:01:08 Heather Hall
You know, I'm not really included in that.
00:01:09 Heather Hall
That doesn't happen to me, another I think thought that people tend to have is that global health issues are rich versus.
00:01:17 Heather Hall
Poor, you know it's.
00:01:18 Heather Hall
We'll discuss more about this later.
00:01:21 Heather Hall
But a lot of times eight you kind of.
00:01:23 Heather Hall
I think that.
00:01:24 Heather Hall
If you're a rich country, you know.
00:01:25 Heather Hall
You're not really going to have global health issues.
00:01:27 Heather Hall
That that's something.
00:01:28 Heather Hall
That happens in poorer countries or less developed countries.
00:01:30 Heather Hall
But it's actually not always right to think that just because the country is rich and that they have maybe one of the best health care systems in.
00:01:38 Heather Hall
The world that.
00:01:39 Heather Hall
They necessarily automatically have the healthiest people.
00:01:42 Heather Hall
That's actually not the case.
00:01:43 Heather Hall
And then one final thing is that often with global health, people tend to think of global health as something that happens or occurs during an emergency.
00:01:51 Heather Hall
Really a lot of what global health.
00:01:53 Heather Hall
Entails has to.
00:01:54 Heather Hall
Do with non emergent times.
00:01:56 Heather Hall
Obviously the pandemic that just happened is a big example of an emergency, but there is a lot in global health and global health issues.
00:02:05 Heather Hall
That involve the.
Everyday health of.
00:02:07 Heather Hall
People every day health and well-being of people.
00:02:10 Heather Hall
All around the world so.
00:02:11 Heather Hall
Yeah, these are a couple of things that I.
00:02:12 Heather Hall
Would I would add.
I I completely agree.
The stance of thinking that things are an emergency.
I'm really glad.
00:02:19 Heather Hall
You highlighted the US versus them.
And you know this.
Is something that only happens to poor?
People this mentality is really how the field of global health emerged that historically in the 19th century European powers gathered together and they would discuss epidemics across borders and quarantine requirements around diseases like cholera, big emergency.
There's a cholera epidemic.
They would come together and discuss how they were going to do quarantine.
And this 19th century like mindset is of course around the same time as imperialism.
The scramble for Africa, the colonial period, and that's what led to the emergence of this term called colonial medicine.
And over time, this term transitioned to Tropical Medicine, which was characterized by the study of diseases like yellow fever, malaria diseases that are usually found in the tropics after World War Two.
You know, at the.
00:03:10 Heather Hall
End of this sort of colonial period.
We see the term international health emerge and it's used to describe the prevention.
And treatment of infectious diseases.
Is around the same time.
After World War Two, The Who.
Forms in 19.
48 and they began the work of identifying ways to treat and control infectious diseases, so they began massive campaigns on the smallpox eradication. We see really big attempts in eradicating malaria. But by the 1980s, this term international.
Health kind of fell out of favor.
A lot of it has to do with this colonial history and how it was applied.
So international health was often a tool for reinforcing authority over people groups.
A lot of people that work in the field of global health don't use the.
Term because of its association with colonialism.
And hegemony also, during this time, you know in.
The 80s we see the Dibuat show the World Health organizations.
Falling under criticism.
Because it was.
Focusing on infectious diseases, but it wasn't bringing in a focus on health care, delivery or infrastructure, or other things like that.
They contribute to the burden of disease.
Because of this negative history, this colonial history, this rich versus poor mentality.
And the limited scope of work that.
The show is.
Doing in the 1990s, the term global health.
Began to be used.
Global health is really a field of work that begins with the work of international health that work of treating and preventing infectious diseases.
Things like improving hygiene and water supply, promoting child and maternal health, but.
Global Health is a field brings in what the.
Dibuat Show was was.
Criticized for not having a focused on National Health.
Systems it puts the spotlight on health financing with.
Problems universal health coverage.
Access to health care in rural.
Areas and other local and regional.
Challenges, which we'll talk about some of them today.
Global Health also brings in the discipline of public health, public health, I know, is a term that many of you probably heard used and have some basic understanding of public health.
Is this upstream?
Approach to health care.
It focuses not just on disease.
Burden and treatment but on.
Social determinants of health and illness and health inequality.
And how these inequalities are due to unequal distribution of social, political, economic opportunities?
In summary, a lot of global health does have that focus, like we talked about before this focus on mass mobilization around new and emerging diseases.
But it also brings in these other approaches of looking at health from a social.
And from a systems.
Approach the most common definition of global health is that it is an area for study, research and practice that prioritizes on improving health and achieving HealthEquity for all people worldwide.
And that is because global health.
Is not just a focus on cross-border health problems, it's an approach that seeks to ensure the health of all people.
It's everyone, it's all hands on deck.
That's what global health?
Is you know, so we're done, we don't.
Need to talk anymore.
I'm sure most.
Of you guys know?
That the way something is defined is often very.
Different from how it's applied.
In the fields.
So that's why we brought Heather on to talk with us.
About what global?
Health looks like Heather has a graduate.
Degree in global public health nursing.
She's previously worked as a nurse in Kenya and done some consulting public health work in Kenya and a few other African countries.
She is the former program coordinator for tuberculosis refugee immigration programs at the Health Department in Ohio and recently did some COVID-19 policy work for a health department in Oregon. So Heather again. Thanks so much for joining us.
00:06:47 Heather Hall
Thanks so much for having me.
00:06:48 Heather Hall
I'm glad to be here.
00:06:49 Heather Hall
I love talking about global.
Public health, so how that?
Before we really get into.
A deep discussion of this topic I.
Think it would.
Be really useful for those who are listening to go through.
A few of the key.
Terms in the field of.
Global health for people you know who have been.
Working in the.
Field, it's really easy to start throwing around vocabulary.
And I want to make sure that our.
Listeners have a clear.
Understanding of what we mean when we say certain.
Terms I think I'll begin with a term that is really important in this field, which is chronic versus infectious diseases chronic.
Uses also are called non communicable diseases, which means that you can't spread them between people, and they're usually defined as conditions that last for one year or more.
They require ongoing.
Medical attention and they can limit the activities of.
Daily living when we think chronic.
Diseases we think of diseases like.
Diabetes heart disease, cancer those are the.
Top three most common diseases that are noncommunicable or chronic infectious diseases.
These are diseases that spread from person to person.
Things like the flu or malaria or measles or chicken.
Box those are infectious diseases.
00:07:52 Heather Hall
And it's also important to note that while you do have things that are chronic diseases versus infectious diseases, it's important to note that there are occasions where you know the line between infectious diseases and chronic.
00:08:04 Heather Hall
Diseases can actually blur.
00:08:05 Heather Hall
You know, just because something is considered an infectious disease doesn't mean that.
00:08:10 Heather Hall
It can't then lead to a chronic condition or chronic disease state, so so take COVID-19 for example.
00:08:16 Heather Hall
We've all probably.
00:08:17 Heather Hall
Heard about what's called long haulers or it's also termed by the CDC Centers for Disease Control and Prevention based in the United States.
00:08:25 Heather Hall
Long hose is also called long COVID or post COVID.
00:08:29 Heather Hall
Options this is when someone who has been infected with COVID experiences long term effects from their infection.
00:08:36 Heather Hall
They can go until last weeks, months or even years, and some of us maybe even know.
00:08:41 Heather Hall
Some of these people.
00:08:42 Heather Hall
And in other words, you may no longer have an active COVID infection, but you're still experiencing the lasting effects.
00:08:50 Heather Hall
From that initial infect.
00:08:51 Heather Hall
Action wrong COVID includes a wide range of effects such as the T cough, difficulty, breathing, even things like depression or autoimmune conditions, heart issues or other multi organ effects.
00:09:04 Heather Hall
We're still learning a lot about COVID, and even now researchers are still learning about all of the different types and severity.
00:09:11 Heather Hall
Of the different long term COVID effects.
00:09:14 Heather Hall
Another example, where kind of that?
00:09:16 Heather Hall
That line between infectious disease and chronic disease can.
00:09:19 Heather Hall
Be blurred is HIV.
00:09:21 Heather Hall
HIV actually turns from an acute or initial infection into a chronic infection.
00:09:26 Heather Hall
So once you get it, you have it for life and then with HIV it also then has the potential to transition from HIV into AIDS if it's left untreated with treatment.
00:09:37 Heather Hall
Many people are able to remain in watts.
00:09:40 Heather Hall
Photo chronic state of HIV infection.
00:09:43 Heather Hall
Where they have.
00:09:44 Heather Hall
The HIV infection and they're still able to transmit it to others, but they they may not really even be having any symptoms so they can remain in this chronic state to where the virus never actually then developed into AIDS.
00:09:56 Heather Hall
AIDS of the kind of final stage or the third stage of HI.
00:10:00 Heather Hall
B and if if that person with HIV is able to have treatment, has access to treatment or resources, most people are able to live a long and healthy life.
00:10:08 Heather Hall
However, if that person does not have access to treatment once HIV turns into AIDS, the individuals immune system becomes severely weakened and that person can then become very susceptible.
00:10:20 Heather Hall
To what we?
00:10:20 Heather Hall
Call opportunistic infections, or which are essentially infections that are waiting for an opportunity to kind of wreak havoc.
00:10:28 Heather Hall
Some examples of these type of opportunistic infections are pneumonia, tuberculosis, various types of cancers.
00:10:34 Heather Hall
Once a person develops aids and then has one of these opportunistic infections, the the prognosis is usually very poor, so the outcome unfortunately is not is not a desirable outcome.
Thank you mother.
I'm glad you brought that up.
A lot of people either have a focus on chronic diseases and no focus on infectious diseases or vice versa, but the two fields really are aligned.
Well, together you see that people who.
Of infectious diseases can lead to chronic conditions and even having a chronic condition can make you susceptible to an infectious disease.
They do work in.
Tandem together and I'm glad that we discussed that a.
Terms of how chronic disease and infectious diseases have changed over the course of the global health timeline.
We see that chronic diseases are on.
The rise and infectious diseases are trending down, which I'm sure many of you listening.
Are aware of that.
Worldwide few people are dying from infectious diseases and.
People are living.
To be older and then dying of chronic diseases, diseases like diabetes, cancer or heart disease.
Are collectively responsible.
For over 70% of deaths worldwide, which amounts to about 41 million people, so most people are dying from chronic diseases now. But the battle against infectious diseases has not really been won yet. Still 17 million people die from infectious diseases worldwide, and the reason that.
I bring this out.
The epidemiological transition.
Try saying that five times fast.
The reason that I bring up this trend.
Is that there are many countries that are in the.
Middle of this.
They have really high rates of chronic diseases rising, but they also still have really high rates of infectious diseases.
This is what we call the.
Double burden of disease and this.
Is important to talk about because when we hear.
00:12:20 Heather Hall
On the news.
About other countries in the majority world.
The focus tends to be on infectious diseases talking.
About malaria children.
Dying of diarrheal disease.
Things like that.
But the truth is, is that many of these places have really high rates of.
Both and in fact there's other.
In many countries there's what's called the.
Triple burden of.
Disease, which is where a country has really high rates of chronic diseases.
They have high rates of infectious.
Diseases and then the triple is.
Accidents, so things like Rd traffic, accidents, burns.
Things like that.
Yeah, people are dying at every life stage.
Of both chronic infectious and accidents, which makes tackling these issues and this.
This approach of taking all three together so important.
00:13:05 Heather Hall
You bring up really great point.
00:13:06 Heather Hall
Yes, mean that you can't necessarily isolate infectious diseases, chronic diseases, and things like accidents.
00:13:14 Heather Hall
You know they are all very intertwined and a lot of times they all have to be addressed simultaneously.
00:13:19 Heather Hall
People might be thinking wow, OK, you guys just covered a lot of different types of issues.
00:13:24 Heather Hall
Where do we even begin?
00:13:25 Heather Hall
You know everything is seems so complex and interconnected.
00:13:29 Heather Hall
And there are different things going on in all.
00:13:31 Heather Hall
Parts of the world so.
00:13:32 Heather Hall
How do we even begin to?
00:13:33 Heather Hall
Have any type of like strategic way to.
00:13:36 Heather Hall
Address all of these things.
00:13:37 Heather Hall
Well, you know, as some people might be aware there is an organization called the United Nations and the United Nations has actually been tasked with this this very thing.
00:13:49 Heather Hall
Addressing all of these global health issues and the United Nations specifically created essentially like a task force called the United Nations Development Program, and their purpose is to strategically help countries eliminate poverty and achieve sustainable economic growth and human development.
00:14:08 Heather Hall
Because, again, as we've you know said before, and we'll touch on quite a bit, all of these things are interconnected.
00:14:13 Heather Hall
You know somebody's health and well-being directly affect their their finances, their the economic health of their family. And so, again, you can't just address 1 issue.
00:14:23 Heather Hall
You know you have to kind of look at the whole picture and the sustainable development Goals, which we'll talk about.
00:14:28 Heather Hall
Here in a minute are designed to help do that, so a little bit of back story in the year 2000, the United Nation created something called the Millennium Development Goals, or MDG's.
00:14:40 Heather Hall
So if you're in the world of public health or global health or anything like that, you probably heard of that before.
00:14:45 Heather Hall
I mean, at the time in the year 2000.
00:14:47 Heather Hall
There were just eight goals.
00:14:49 Heather Hall
So, and these eight goals covered combating poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women.
00:14:59 Heather Hall
And there was.
00:15:00 Heather Hall
Actually, a timeline that was put on this, so there was a timeline of 15 years and so it was thought that we would work on all of these things collectively and that they would hopefully be accomplished by the year 2015. Well, as we all know.
00:15:13 Heather Hall
2015 world around and there's still a lot.
00:15:16 Heather Hall
Of these issues.
00:15:17 Heather Hall
At play, and so then in 2015, the UN development programme. They took those Millennium Development Goals and actually broadened them and then adopted them into what are now known as the Sustainable Development Goals. So which are essentially.
00:15:34 Heather Hall
It's a universal. They are a universal call to action to end poverty, protect the planet, and ensure that by 2030.
00:15:40 Heather Hall
30 All people will enjoy peace and prosperity now instead of eight like there were in the Millennium Development Goals, the Sustainable Development Goals or SDG's. There are now actually 17 goals in total.
00:15:54 Heather Hall
And they're all viewed from the understanding.
00:15:56 Heather Hall
Again, like I said that each goal is interconnected and so action.
00:16:01 Heather Hall
And one goal.
00:16:02 Heather Hall
Can affect the outcome in another goal.
00:16:06 Heather Hall
So like I said, there's 17.
00:16:07 Heather Hall
Of these goals, and.
00:16:08 Heather Hall
I'm actually going to.
00:16:08 Heather Hall
Read reading each one of them because I think it's really good to get a comprehensive picture of everything that global health entails and how all of these things.
00:16:20 Heather Hall
Again, how they all affect one another.
00:16:22 Heather Hall
So the first is the first sustainable development goal is no poverty.
00:16:26 Heather Hall
Number 20 hunger #3 good health and well-being #4 quality education #5 gender equality #6 clean water and sanitation.
00:16:39 Heather Hall
#7 affordable and clean energy #8, decent work and economic growth. #9 industry innovation and infrastructure. Number 10. Reduced inequality #11. Sustainable cities and communities number.
00:16:54 Heather Hall
Responsible consumption and production number 13 climate action.
00:17:00 Heather Hall
#14 life below water #15 life on land #16, peace, justice and strong institutions and finally #17 partnership.
For the goals.
00:17:12 Heather Hall
So hopefully all of our listeners are still here.
00:17:15 Heather Hall
With us 'cause I know that was a.
00:17:16 Heather Hall
Really long list, but again I think.
00:17:18 Heather Hall
It's important to read out each one of those.
00:17:20 Heather Hall
Things because peers, again, they're all interconnected and there.
00:17:23 Heather Hall
Might be things in there.
00:17:24 Heather Hall
There well that we maybe maybe don't necessarily think of as being associated with global health and with just, you know, the overall health and well-being of people all throughout the world.
00:17:35 Heather Hall
But it's really important that what we can.
00:17:38 Heather Hall
Name those things.
00:17:39 Yasmine Vaughan
A little bit more.
00:17:40 Heather Hall
About the dogs.
00:17:41 Heather Hall
The dogs were set to be accomplished.
00:17:43 Heather Hall
Again, by the year 2030.
00:17:45 Heather Hall
Which we're not.
00:17:46 Heather Hall
There yet, but as you can imagine, you know.
00:17:48 Heather Hall
We have just.
00:17:49 Heather Hall
Experienced a very long pandemic, the COVID-19 pandemic and again as you can imagine that pandemic has set back a lot of progress on these goals.
00:18:00 Heather Hall
More specifically, new research by the United Nations Development Programme shows that the long term social and economic impact of the pandemic will actually is actually set to widen the gap between people living in rich and poor countries.
00:18:15 Heather Hall
So you know.
00:18:15 Heather Hall
We all know that.
00:18:16 Heather Hall
There's this gap between kind of your rich levels of society.
00:18:19 Heather Hall
And in your poor levels of society.
00:18:21 Heather Hall
And because of the pandemic, it's just going to increase that gap, and unfortunately it's the poor countries that are increasingly bearing.
00:18:29 Heather Hall
The brunt of COVID-19 cases and the.
00:18:32 Heather Hall
Related mortality with that.
00:18:34 Heather Hall
Now for a few more specific examples of how the pandemic has affected the SDGS, let's go ahead and just take a quick look at the first SDG, which is no poverty.
00:18:43 Heather Hall
So before the pandemic, about 1 billion children, which is about the population of China.
00:18:49 Heather Hall
Lacked basic necessities such.
00:18:51 Heather Hall
As clean water and nutrition, however now due to Co.
00:18:55 Heather Hall
David, there are now 150 million more children experiencing this level of poverty. You know? So 100.
00:19:02 Heather Hall
And 15 million more.
00:19:03 Heather Hall
That is, that is significant.
00:19:04 Heather Hall
That is huge.
00:19:05 Heather Hall
So again, you can kind of see how that increase in.
00:19:08 Heather Hall
Number has really has really shifted.
00:19:11 Heather Hall
The progress towards.
00:19:12 Heather Hall
The goal of no poverty and then another one.
00:19:15 Heather Hall
Is again also related to the first SDG of no poverty.
00:19:19 Heather Hall
The pandemic has also increased the number of orphans involved.
00:19:22 Heather Hall
Well, children in the United States alone, more than 140,000 children lost a caregiver due to the pandemic per the CDC, and as you can probably imagine, losing a caregiver significantly increases a child vulnerability, especially to poverty, and especially if the country does not have an established child welfare system. So again, you know I don't need.
00:19:41 Heather Hall
To say anymore.
00:19:43 Heather Hall
The pandemic has definitely put us back with some of these with some progress towards these.
00:19:47 Heather Hall
Goals thank you, Heather.
I'm glad you've highlighted this interconnectedness of these issues.
You know, we said Goal 3 is good.
Health and well-being but.
I'm glad we mentioned all the others.
It is all connected. Issues like poverty,
climate change, access to water and sanitation.
These things all have an impact on health.
For people who don't have the ability to afford healthcare, sanitation and water obviously have a big impact on health.
Things like that, as you're saying before, global health brings in this interdisciplinary perspective of not just looking at how.
To how to treat an illness.
But looking upstream, what are the other things that are influencing
And playing into health?
We'll be back in a Minute with more on this topic.
You're listening to optimistic voices Podcast with host Yasmine Bon and guest Heather Hall For more information on today's topic. Global health go to helpingchildrenworldwide.org Optimistic Voices Podcast season one, Episode three,
We rejoin the conversation on strategic development goals.
00:21:02 Yasmine Vaughan
SDG Three has specific targets in the field and many of these dominate a lot of the work that is being done in global health.
So Heather, let's let's talk a little bit.
About some of
The big targets in global health.
Some of the the big topics that are SDG, three is looking to tackle.
00:21:19 Heather Hall
I oftentimes we'll talk about the dogs as they relate to global health. You know, even though there are certain SVG's that may be a little more obvious than.
00:21:28 Heather Hall
Others, but again to me.
00:21:29 Heather Hall
As a global.
00:21:30 Heather Hall
Public health person.
00:21:31 Heather Hall
They're all again, like I said, interconnected.
00:21:33 Heather Hall
But more specifically, there are some dogs specifically.
00:21:37 Heather Hall
Rate relate to the topic of global health.
00:21:40 Heather Hall
The first one, which is pretty obvious is SDG. #3 and #3 is good health and well-being, and as you can imagine that can cover.
00:21:50 Heather Hall
A whole host of.
00:21:51 Heather Hall
Topics now we'll just cover a few of the major topics, but especially the ones that you often find in global health.
00:21:59 Heather Hall
So the first one is maternal child health, maternal and child health are two of the leading health indicators of a country.
00:22:06 Heather Hall
And as you can imagine, are very closely linked, so maternal health specifically refers to the health of women during pregnancy.
00:22:14 Heather Hall
Childbirth in the post Natal period.
00:22:17 Heather Hall
Now, the reason maternal health is an important indicator is because most maternal deaths are preventable as long as there's timely management by a skilled health professional, you know in in a supportive environment.
00:22:30 Heather Hall
Again, not having those things or having those things can really tell the story of the health of the infrastructure.
00:22:38 Heather Hall
Of a country.
00:22:40 Heather Hall
Now, maternal deaths are measured using the maternal mortality rate, and so a lot of times if you're talking about maternal health, this will be the most common statistic that you'll hear.
00:22:49 Heather Hall
So maternal mortality rate and per the WHL, which stands for World Health Organization, maternal mortality is unacceptably high, about 200.
00:23:00 Heather Hall
And 95,000 women died during and following pregnancy and birth in 2007.
00:23:05 Heather Hall
Team and I first just want to say.
00:23:07 Heather Hall
00:23:08 Heather Hall
Like OK, That's 2017, that's almost.
00:23:10 Heather Hall
Five years ago.
00:23:10 Heather Hall
But as you can imagine, it takes a lot of time to collect a lot of this information, so so some more recent statistics you know are probably still in development.
00:23:20 Heather Hall
Now again that out of those 295,000 women, the vast majority.
00:23:25 Heather Hall
Of these deaths.
00:23:26 Heather Hall
00:23:27 Heather Hall
Percent actually occurred in low resource settings, and again could have been prevented with sub-Saharan Africa and Southern Asia, accounting for approximately 86 of that 94% of deaths. So again, that's you know by far the majority. So again, keep it. Keep that in mind.
00:23:48 Heather Hall
And you know, just kind of as a real world example.
00:23:51 Heather Hall
Countries countries know how important maternal health is, and they've specifically put measures in place to try to improve maternal health.
00:24:02 Heather Hall
For a personal example, or something that I have seen first here.
00:24:05 Heather Hall
And when I was in Kenya working as a nurse there and again, Kenya is a sub-saharan African country.
00:24:13 Heather Hall
So if you're not quite sure where that is, if you look at Africa, it's it's on the eastern side on the eastern coast, and Kenya actually requires all of their nurses to be midwives and one time.
00:24:25 Heather Hall
When I was out with the immunization clinic and the antenatal clinic in Ken.
00:24:31 Heather Hall
Yeah, a woman actually came to the clinic in active labor again, you know, that wasn't the purpose of the clinic, but she knew that we were having a clinic there and and came to try to get some help.
00:24:43 Heather Hall
And because Kenyan nurses are already trained for this, thankfully, the nurse midwife who was already at the clinic, you know she already had.
00:24:51 Heather Hall
The supplies and skills to provide this woman with the access to health care that she needed at this crucial moment.
00:24:58 Heather Hall
So again, you know.
00:24:59 Heather Hall
The you know we weren't expecting to have anybody you know an active delivery but but they were prepared already again prepared with those skills and supplies and thankfully the woman had a successful delivery in birth and both mom and baby left the left the clinic healthy and well.
00:25:17 Heather Hall
So was we're very thankful that that.
00:25:19 Heather Hall
Was a positive story.
00:25:21 Heather Hall
And then moving on to child.
00:25:23 Heather Hall
Health and child health.
00:25:25 Heather Hall
Again, like I said, they're very interconnected, but maternal health and child health are very interconnected and you know.
00:25:31 Heather Hall
Child health is.
00:25:31 Heather Hall
Fundamentally important, and covers the span of a child's life. You know from from birth even before birth, up until they reach adulthood. But one of the most important global.
00:25:43 Heather Hall
Health focus is related to child health is the health of children under the age of five, and I'll go ahead and let you Yasmine talk a bit more about that.
Yeah yeah, under under 5 mortality is one of my I don't want to say one of my favorite topics because that sounds terrible, but it's a it's a topic is very close to my heart.
So under 5 mortality is the the measure of the likelihood a child will die before they reach their 5th birthday.
And like Heather said, with maternal mortality, it's an important measure of the health of the population and of the development level of a nation.
And this is because you know pregnant women and children are among the most vulnerable members of a population.
So with the Under 5 mortality and maternal mortality rifl.
Next is the strength of a health system to support its most vulnerable, and it's used as a measure of the social economic and, you know, environmental conditions in which communities live.
So you know, that's why, like these two measures in particular is so often used so worldwide.
You know we're seeing a lot of trends.
Down and and.
Under 5 mortality, so the total number of under 5 deaths has declined from 12.6 million in 1990 to 5,000,000 in 2020, so 7.6 million decline in the last 30 years, which is really wonderful.
But you know, still children in you know regions like sub-Saharan Africa tend to have the highest rates of under 5 mortality in the world, in fact.
Sub-Saharan Africa has 14 times higher the risk of children than Europe and North America and this is important because.
While sub-Saharan Africa and Southern Asia account for more than 80% of the Under 5 deaths, they only account for 53% of the global live birth rage.
So we see this tension.
There's more children dying than there are being born and.
Really, illnesses that cause deaths.
Of children under 5.
Are largely preventable.
Treffle treatable, and for the most part, relatively inexpensive and easy to do, and we'll do a whole other episode on Under 5 mortality and bring in some other speakers to talk about this, but it's a.
It's an important measure and it's.
Uhm, it's actually one of my favorite parts about the work that we do at Mercy Hospital.
So we have an Under 5 clinic every Thursday at Mercy Hospital.
Mothers and bring their children and they receive checkups.
Treatment for diseases?
There's a representative from the World Health Organization.
Who comes specifically On that day.
To give immunizations.
It's really wonderful to.
Sit in on that, uhm.
I mean of course.
The children hate the immunizations part.
You know they get like 6 sticks.
In the arm when they're.
There, but it's so.
Impactful because you see that you.
Know after being at the clinic for maybe an hour and an hour and a half.
You know these kids get couple of vaccines if they have, you know, a diarrheal disease.
They get some antibiotics and then these kids are one step closer to seeing their 5th birthday, so building that infrastructure like we said is such an important an important part of global health and that's why these two measures are so important.
00:29:12 Heather Hall
00:29:13 Heather Hall
And and and something that that really connects closely with child health is also malnutrition.
00:29:21 Heather Hall
Malnutrition more specifically includes undernutrition such as wasting stunting and under being underweight.
00:29:30 Heather Hall
It also includes inadequate vitamins or minerals, but malnutrition also includes overweight and obesity.
00:29:37 Heather Hall
And and non communicable diseases that are diet related.
00:29:43 Heather Hall
So I think a lot of times when people think about nutrition, they think of children who are underweight.
00:29:47 Heather Hall
But it actually also includes children and adults that are that are overweight.
00:29:53 Heather Hall
Now as you can, as you can guess, malnutrition has always been an important part of global health, and it's also a really great example, again, of how the SDG's overlap.
00:30:04 Heather Hall
So SDG #2, which is ending hunger, is then also linked to SDG #3 good health and well-being.
00:30:12 Heather Hall
Now you know this is a move that we all know. We all know that nutrition is important and foundational to good health and well-being and malnutrition you know can really for some people mean life or death.
00:30:24 Heather Hall
You know, especially for a child, and if you have a child that's malnourished and therefore you know they get sick.
00:30:32 Heather Hall
Because they are malnourished their their body is less prepared to fight.
00:30:37 Heather Hall
Or even easily bounce back from a major illness and sometimes even some. You know minor illnesses. So again that non nutrition or I'm sorry nutrition is foundational to just overall health and well-being in your ability to to handle other diseases or illnesses that might come your way.
00:30:55 Heather Hall
For a few statistics, the global the excuse me. The WHL reports that globally in 2020, a 149 million children under five were estimated to be stunted and stunted. Specifically, means.
00:31:09 Heather Hall
That they're too short for their age.
00:31:11 Heather Hall
And then there were 45 million children who were estimated to be wasted, which means that they're too thin for their height.
00:31:19 Heather Hall
And then there were 38.9 million who were overweight or obese. So again, just looking at those three statistics, the majority of of malnutrition in children has to do with stunting.
00:31:32 Heather Hall
00:31:33 Heather Hall
Excuse me and then the the lower end has to do with children that are.
00:31:37 Heather Hall
Overweight or obese?
00:31:39 Heather Hall
Now also, around 45% of deaths among children under 5.
00:31:44 Heather Hall
Years of age.
00:31:45 Heather Hall
Are actually linked to undernutrition and these occur in low and middle income countries.
00:31:52 Heather Hall
However, at the same time in these countries, rates of childhood overweight children being overweight and.
00:31:59 Heather Hall
Obese are actually rising, so this touches again what Yasmine was talking about earlier that you know you kind of have this intersection of of issues so you have issues of children that are malnourished, but then at the same time you know that maybe are experiencing.
00:32:17 Heather Hall
Hey undernutrition, but then at the same time you may have an increasing rate of children who are overweight and obese, so especially as you have that, that widening gap between maybe the rich parts of society and the poorer parts of the society.
00:32:31 Heather Hall
So countries really have.
00:32:32 Heather Hall
To figure out how to address both of.
00:32:34 Heather Hall
Those so so again, as we've already discussed.
All of these.
00:32:39 Heather Hall
Issues are linked and with malnutrition.
00:32:41 Heather Hall
Poverty can really amplify their risks of and the risks from malnutrition.
00:32:47 Heather Hall
So like I just was talking about.
00:32:49 Heather Hall
And people who are poor are more likely to be affected by different forms of malnutrition versus maybe people who are rich, rich and then also malnutrition increases health care costs as well as reduces productivity and slows economic growth.
00:33:04 Heather Hall
Which again, if you are somebody who's living in, you know a situation of poverty.
00:33:10 Heather Hall
You know having issues with malnutrition and then the the the ending results can really be put in a cycle of poverty that can go on for years and years and even even potentially generations.
00:33:25 Heather Hall
When I worked in Kenya, I worked with a Community health and development program and specifically got to work with their wash program and what wash stands for is an acronym for water, Sanitation and Hygiene, and one of the.
00:33:40 Heather Hall
Of their program.
00:33:42 Heather Hall
Was for both schools.
00:33:44 Heather Hall
And individual homes to start their own garden.
00:33:47 Heather Hall
And not only did this help teach the children about healthy foods and what are good things for them to eat that can easily be grown in their area, but it also taught them a valuable skill that could not only help provide food for their family, but also you know it provided them with a skill that they could potentially maybe even make.
00:34:07 Heather Hall
Into a business opportunity in the future.
00:34:09 Heather Hall
So again, it's just a really great example of how all of those things are interconnected.
Yeah, Heather, thank you so much for that summary of malnutrition.
Another big topic in global health, ironically, is what are called neglected tropical diseases and and the reason that we call these diseases neglected is because unlike you know, big names in infectious disease like HIV and malaria, there's actually not.
A lot of.
Global funding or attention paid to these diseases come.
And these include conditions like.
Onchocerciasis, also known as river blindness, schistosomiasis, lymphatic filariasis, trypanosomiasis.
These are, you know, disease conditions that I'm sure many of you have never heard of and are currently trying to figure out how to spell.
Them so you can Google them.
But they're they're neglected because more than one.
Billion people, or you know about 1/6 of the world population suffer from at least one of these neglected tropical diseases.
And you know most of these diseases are not fatal.
They rarely lead to death, but what they do is cause significant disability.
So many of them lead to blindness or disfigurement, fatigue, you know these chronic conditions, and if you are disabled because of.
One of these diseases you know, then you're unable to work.
You're unable to provide for yourself, and this goes back to what we were saying before about the cycle of poverty for disadvantaged people.
If you can't.
If your your health impacts your economic ability, and again for.
Many of these diseases and conditions they can be prevented through surveillance and simple cost effective interventions.
And again, a lot of this ties back to access to health care for resource poor communities.
00:36:07 Heather Hall
Yeah great thanks Jasmine.
00:36:09 Heather Hall
I I always find it really interesting and fascinating to hear about the, you know.
00:36:15 Heather Hall
Neglected tropical diseases because because again when you go to some of these, these international places, global places where you see things that aren't in your maybe in your home country, it just really brought into your perspective on what people in other parts of the world might be dealing.
00:36:31 Heather Hall
With so now for a few diseases that people might be a little bit more familiar with.
00:36:36 Heather Hall
There is also obviously.
00:36:38 Heather Hall
HIV, malaria, and tuberculosis, which again are very prominent topics in global health.
00:36:45 Heather Hall
And you know, much can be said about each of them, so I'll just try to keep this brief.
00:36:50 Heather Hall
But again, these are three issues that you know have been major focuses in global health, and they probably will continue.
00:36:58 Heather Hall
To be for quite.
00:36:59 Heather Hall
A while and and one of the reasons that they're important is because they can be easily spread.
00:37:05 Heather Hall
And then of course have very serious consequences if people don't have access to treatment.
00:37:11 Heather Hall
So more specifically about HIV, which I know we've already touched on a bit, but it's important to remember that you know, while there have been significant advances in the treatment of HIV, and many people are still able to live long and healthy lives, there is still no cure for the disease.
00:37:28 Heather Hall
And while there are medications
00:37:31 Heather Hall
I hope you live a long and healthy life.
00:37:33 Heather Hall
You know, those medications don't really do you any good if you don't.
00:37:36 Heather Hall
Actually have access to them.
00:37:39 Heather Hall
In addition, there are still many cultural practices and beliefs in a lot of different parts of.
00:37:44 Heather Hall
The world that increase the risk of HIV transmission.
00:37:48 Heather Hall
And you know, if you think about it, if you have an increased risk of transmission and limited access to HIV therapies, then the results of these risky behaviors.
00:37:58 Heather Hall
Can actually have really significant impacts, not just on individuals, but whole communities.
00:38:04 Heather Hall
So for example, there are many places in the world where there are large amount of orphans due to losing their parents to AIDS.
00:38:11 Heather Hall
In 2020 there were estimated there was an estimated 15.4 million children, ages 0 to 17 who have lost one or both parents due to HIV. I'm sorry due to AIDS globally, per the United Nation aids.
00:38:27 Heather Hall
Again, these issues are very interconnected and progress or regression in one can mean progress or regression in.
00:38:35 Heather Hall
Now 2 diseases you know there might be a little a bit lesser known and are are more rare in the United States for malaria and tuberculosis.
00:38:44 Heather Hall
So you've probably heard about them.
00:38:46 Heather Hall
But you know, maybe really don't know much about them.
00:38:48 Heather Hall
So malaria is a actually a life threatening disease.
00:38:52 Heather Hall
Can be life threatening and is.
00:38:55 Heather Hall
Caused by parasites that are transmitted to people through the bites of infected mosquitoes.
00:39:00 Heather Hall
But again, thankfully, this malaria is a disease that is preventable and curable.
00:39:05 Heather Hall
In 2020, there were an estimated 241 million cases of malaria worldwide and 627,000 deaths in 2021. Very important in common initiative in global health to combat malaria is the use of bed Nets, so you can actually use.
00:39:26 Heather Hall
Treated bed Nets and some of you maybe have even seen or used these before, but these bed Nets are treated and put over somebody bed or sleeping place.
00:39:36 Heather Hall
And and obviously the goal is to help prevent people from being bitten by mosquitoes while they're asleep and and when, again, when.
00:39:44 Heather Hall
I worked in Kenya with the wash program.
00:39:47 Heather Hall
This is actually one of the requirements for people who are participating in their in their water program.
00:39:53 Heather Hall
And they they had to have bed Nets, and thankfully, most people you know, we're pretty accepting of that.
00:40:00 Heather Hall
But it is also important to to educate people on the use.
00:40:04 Heather Hall
You know it, you don't just pass out something and not educate someone on how to use it.
00:40:09 Heather Hall
You know I have.
00:40:10 Heather Hall
Heard stories before.
00:40:12 Heather Hall
You know people using bed Nets for for uses other than what they were designed for, such as even like a fishing Nets.
00:40:18 Heather Hall
So it's really important that when you are using some of these public health interventions that it is accompanied by appropriate education, and again, that education may need to be reinforced now, moving on.
00:40:32 Heather Hall
To tuberculosis, many people think that tuberculosis is something that only happens in developing countries.
00:40:38 Heather Hall
Again, one of those things of, well, that just happens to them over there, but it's actually important to know that yes, while it is less common in the United States, it still does actually happen here.
00:40:50 Heather Hall
In the United States, as I'm imagining, most of our listeners are probably based in the United States.
00:40:57 Heather Hall
But tuberculosis also called TB, is caused by a bacteria.
00:41:01 Heather Hall
And is it most often affects the lungs, though it can actually occur in other parts of the body and TB that affects you in your lung.
00:41:09 Heather Hall
Times is most often spread through coughing, sneezing, or even in your spit, and it's actually estimated that one quarter of the world population is actually infected with TB because TB actually has two different phases has.
00:41:24 Heather Hall
What we call.
00:41:25 Heather Hall
A latent phase.
00:41:26 Heather Hall
Kind of like the TB infection is asleep in your body.
00:41:30 Heather Hall
And then it also has an active phase where you're actively sick and you can spread it to people so that one quarter of the world population who are infected.
00:41:39 Heather Hall
Some are probably, you know, having latent TB so they're not actually spreading it at the moment, but but they still are.
00:41:45 Heather Hall
Infected with it.
00:41:46 Heather Hall
And again, thankfully with tuberculosis like malaria, tuberculosis is preventable and curable.
00:41:53 Heather Hall
However, even though it is again preventable and curable.
00:41:58 Heather Hall
There are still 1.5 million people who die each year from tuberculosis, which actually makes tuberculosis the world top infectious killer.
00:42:07 Heather Hall
In addition, it's also the leading cause of people leaving cause of death for people with HIV, so again, you kind of put those two things together.
00:42:18 Heather Hall
You take a very vulnerable population of.
00:42:20 Heather Hall
People with HIV.
00:42:21 Heather Hall
And then the fact that tuberculosis is the world top infectious killer, you know.
00:42:28 Heather Hall
That you can see why TB is a very important global health issue.
00:42:34 Heather Hall
When I was in Ohio and I was a program coordinator for our tuberculosis program, so we we would take care of people who were actively sick with tuberculosis and as part of their care.
00:42:47 Heather Hall
The patients with TB would often be surprised to find.
00:42:50 Heather Hall
Out that we actually.
00:42:51 Heather Hall
Had to watch them take their TV medication.
00:42:54 Heather Hall
You know, and not just kind of.
00:42:56 Heather Hall
You know, watch them every once in a while.
00:42:58 Heather Hall
But we had to.
00:42:58 Heather Hall
Actually watch them take their medication every single time and document that.
00:43:02 Heather Hall
But what people didn't quite know at 1st and what a lot of people.
00:43:06 Heather Hall
Don't know about tuberculosis.
00:43:07 Heather Hall
Is that not finishing your TV antibiotics or you know most antibiotics for that matter, it can lead to what we call an increase.
00:43:16 Heather Hall
In drug resistant TB.
00:43:18 Heather Hall
And and that's actually a very scary thing to think about, because again, if you think about the world's top infectious killer and then the potential that all of the medications that we have to to fight that disease are no longer effective, you know that creates a very dangerous situation and can really affect a lot of people.
00:43:39 Heather Hall
Uhm, so again, back to these patients.
00:43:42 Heather Hall
In in Ohio we would actually go to their homes for months on end.
00:43:46 Heather Hall
You know, five days a week and go for months on end and watch them take their their TV meds.
00:43:52 Heather Hall
But thankfully again now with technological advances there are even options where.
00:43:57 Heather Hall
Patients can take their tuberculosis medication.
00:44:00 Heather Hall
You know, over some kind of video platform or even record it and then send it into their health care professionals so you know, once you're able to really explain that to people and why that's so important.
00:44:14 Heather Hall
Most people are willing to willing to comply, so.
00:44:17 Heather Hall
So yeah, so that's a little bit of interesting information about TV that a lot of people might not actually know.
Yeah, thank you Heather, for that summary of, I mean, these are three really big topics in global health.
You know there's a an organization called the Global Fund which is all about tackling HIV, tuberculosis, and malaria as those three big topics.
So you know, we're trying to go a mile.
Wide and an inch deep on each of this, and perhaps in future episodes, we'll do some focus on these topics.
More specifically, I want to circle.
Back to the point you made.
About antibiotic resistance we'll.
Talk about that again.
More in a minute.
How important that is globally and and I I appreciate what you said about how TV has this latent phase, which again goes back to this idea of chronic versus infectious diseases.
It's something you can have for a long time and not have any idea about and I, I really appreciate how you've highlighted that TB is something that is.
Seen in the United States, I actually had a conversation a few weeks ago.
I was talking about the tuberculosis situation in the Philippines with someone and they said, oh, I thought I thought we had eradicated tuberculosis.
You know, I thought we were done with that, like smallpox.
And you know, for a lot of the world, TB is again still the top infectious killer and is a really debilitating disease.
It's one of the oldest diseases we have to.
It's one of the one of the originals we like to say.
It's been around.
For a really long.
Time and efforts to eradicate it are are underway.
Uhm, I also want to highlight that HIV is still a big problem in the United States, especially among some of the most vulnerable populations it tends.
To you know.
When we think about it in a.
In African or an Asian context, we associate it more with mothers and children and when we think about it in the United States, we think about with drug users.
Men who have sex with.
Men, some populations that are not necessarily glamorous to work with, but.
Are among the most vulnerable and therefore the most vulnerable to diseases.
We'll be back in a minute with more on this topic.
You're listening to optimistic voices. Podcast with host Yasmine Bon and guest Heather Hall For more information on today's topic. Global health go to helpingchildrenworldwide.org Optimistic Voices Podcast season one.
Episodes this season include UMC campaign for a strong family for every child, short term, mission transformation, the HKW Teachers Learning, Collaborative impacting maternal infant mortality rates with champs, the Foundation for orphans.
Embracing Transformation, University of Maine Honors College train the trainer attachment theory workshops for low resource environments and pre literate populations.
Another area that I'd like to highlight that's really important in global health, and that is a big topic right now, of course, is vaccine preventable diseases.
So there are over 25 diseases worldwide that can be prevented with vaccination and there are 15 diseases for which vaccines are currently being developed. They're in the pie.
Online and and you know, many of these I'm.
Sure, you'll know.
About because you've gotten them as a part of your routine immunizations, so you know measles, chicken pox, hepatitis, polio.
You know these are diseases that we don't see in the United States much anymore because of vaccination campaigns, but worldwide.
There are many people that are still dying of these diseases that have a solution.
Just just a simple vaccination and the World Health Organization estimates that vaccination saves about four to 5 million people every year.
So we'll talk a little bit about the global alliance.
For vaccines, they've vaccinated over 888 million children, and averted about 15 million deaths.
Through their work.
And and the the the Gabi as it's called the Global Alliance for vaccines and immunization.
A lot of.
The work that they do is in doing some.
Of the cost.
Efforts around vaccination, so vaccines are really expensive to develop and this organization was formed to share the cost that countries have to pay for vaccinations and so their efforts have really helped.
With some of these conditions, so of course you know cost is a big barrier to this, but vaccine hesitancy, fear of having vaccines is also a really huge barrier to these efforts, and we'll talk more about the the challenges of Community Trust and how that impacts health at a moment.
But I just wanted to highlight.
These vaccine preventable diseases as well.
00:49:43 Heather Hall
Yeah, and I think, uh, yeah, I mean that that that actually leads into the next kind of major global health topic which is emerging and re emerging diseases, you know?
00:49:55 Heather Hall
00:49:57 Heather Hall
'cause we've all seen with COVID, you know, there's you know, been a requirement for vaccination, especially for for travel and and and things like that may become more common as people are traveling more.
00:50:11 Heather Hall
So you know.
00:50:13 Heather Hall
There are diseases.
00:50:14 Heather Hall
That are often isolated to certain parts of the world, but we're now seeing them pop up.
00:50:18 Heather Hall
00:50:21 Heather Hall
Or you know, less common areas and and a lot of that is largely due to the increase in travel to different parts of the world.
00:50:29 Heather Hall
You know, we don't really need a whole lot of explanation on this, because we've all seen this first hand.
00:50:35 Heather Hall
You know, with a few years ago, Ebola and then obviously the globally.
00:50:40 Heather Hall
Disruptive COVID-19 pandemic and then now monkeypox.
00:50:44 Heather Hall
So so yeah, so some of these emerging and reemerging reemerging diseases may become more of an issue again, as we're as we're moving forward and.
00:50:54 Heather Hall
Global health is.
00:50:55 Heather Hall
Is transforming because it's following the the transformation of societies and?
00:51:01 Heather Hall
And yeah so and that.
00:51:02 Heather Hall
That is definitely going to become.
00:51:04 Heather Hall
A larger area of focus in vaccines for preventable illnesses are definitely gonna play a role.
00:51:12 Heather Hall
And then just a little bit about noncommunicable diseases.
00:51:16 Heather Hall
Again, we often think about communicable diseases being a main focus in global health.
00:51:20 Heather Hall
And they are but also non communicable diseases are also becoming a more prominent focus in global health.
00:51:27 Heather Hall
And we touched.
00:51:28 Heather Hall
On this a little.
00:51:28 Heather Hall
Bit earlier now, more specifically non communicable diseases.
00:51:33 Heather Hall
Or actually, diseases that cannot be transmitted to other people such as heart disease, cancer, chronic respiratory diseases, and diabetes.
00:51:42 Heather Hall
The CDC actually states that deaths from non communicable diseases now actually exceed all communicable disease deaths combined.
00:51:51 Heather Hall
And this is the reason.
00:51:53 Heather Hall
Or actually the reason for this is changing social, economic and structural factors such as more people moving to cities and the spread of unhealthy lifestyles.
00:52:03 Heather Hall
Therefore, this will be an increasingly important focus of global health as more and more countries further develop and gain access, you know to unhealthy products, lifestyle, things like that.
00:52:15 Heather Hall
Again, this kind of touches on what you were talking about before his meeting with.
00:52:18 Heather Hall
Kind of that epidemiologic transition.
00:52:22 Heather Hall
So how how are diseases in certain areas changing and a lot of that has to do with lifestyle and the increase in non communicable diseases is a great example of.
00:52:33 Heather Hall
That one kind of real world example is that.
00:52:38 Heather Hall
When I was working as a nurse at a hospital in Kenya, you know I could.
00:52:43 Heather Hall
I could often tell which which patients were from more developed or wealthier parts of the country simply because of the reason that they were there.
00:52:51 Heather Hall
You know they tended to have especially diabetes, that tended to be an issue that they were coming in.
00:52:58 Heather Hall
Info or maybe even heart failure.
00:53:00 Heather Hall
Uh, we were having having some surgeries that were related to to being overweight, so so you know that really does.
00:53:09 Heather Hall
That really does play out as non communicable diseases are are on the rise and really does play out, especially in those countries that.
00:53:18 Heather Hall
You know, maybe don't have the infrastructure to support those because they haven't been used to to addressing those diseases.
00:53:25 Heather Hall
So and we'll talk a little bit more about that later.
Yeah, yeah, I appreciate that.
Bringing back the topic of of chronic disease infectious disease having that double burden in a particular country.
We talked a little bit about this before when we were talking about tuberculosis, but the the last topic I really want to highlight as a.
Big, you know?
Topic in global health.
Is antibiotic resistance.
We might even dedicate an entire episode to.
This in the future.
So as we were saying, you know.
Infections like tuberculosis, but also pneumonia, gonorrhea.
Yeah, these diseases.
Are becoming harder to treat because the antibiotics we use to treat them are becoming less effective and so a lot of this comes from irresponsible use of antibiotics.
So you know a doctor prescribing an antibiotic for a viral infection.
Or when people don't take their antibiotics.
As they are prescribed.
Or in the agricultural industry where antibiotics are used to promote growth in animals?
These things all exacerbate antibiotic resistance there in our ability to fight diseases is diminished, and it leads to longer hospital stays, higher medical cross, increased mortality, so we're increasingly getting closer to a world where we need a better solution to bacterial infections.
Besides antibiotics and we will need to be more vigilant about how we use antibiotics in the future as a result.
So you know, we boy, we've talked for a while now.
This is a not a complete list of all the big topics in global health, but rather a few of the really important ones that affect a lot of people.
And and when it comes to tackling these big issues, there's a number of challenges that clinics nonprofits.
Hospitals health systems are facing and you know, like all of these disease conditions, you'll see that many of these are are interconnected and you know have relations to one another and harkened back to what we're talking about with the sustainable Development goals, you know each of them is.
And has an influence on one another.
You know, for example, one of the.
The big challenges that I think about is.
You know Heather was saying before that chronic disease is becoming a big topic in global health, and as we discussed with the history of global health as a field, the emphasis really was on infectious diseases.
Malaria, smallpox, tuberculosis, diseases like that.
And really, people that work in global health tend to think more about those and not have as much emphasis on these chronic diseases, and so that really impacts how we're able to tackle these issues.
So, for example, in a lot of majority world countries.
Doctors have more training on infectious diseases.
They know more about malaria.
They know more about HIV and they have less training on diabetes management.
And you know how to prescribe medication for.
The endocrinology things these these deeper health topics because the focus is having to shift to include both with this double burden of disease.
00:56:54 Heather Hall
Yeah, that's that's a really great example of some of the challenges that are, you know, that are being faced in in global health and other.
00:57:03 Heather Hall
There another issue or challenge that I think is really important to discuss and I think is becoming more of a focus is, you know the distribution of services or access to healthcare.
00:57:17 Heather Hall
Or you know, or the affordability of healthcare specifically about you know the distribution of services or the supply chain.
00:57:26 Heather Hall
You know of medications as we talked about earlier.
00:57:29 Heather Hall
You know if you have HIV, yes, there are medications that can allow you to live a long and healthy life, but but it's an issue of access.
00:57:38 Heather Hall
Do you actually have access to those medications?
00:57:40 Heather Hall
'cause that's really going to.
00:57:41 Heather Hall
Affect the outcome.
00:57:43 Heather Hall
Also, you know again with the pandemic we we all were aware of the access to vaccines you know.
00:57:51 Heather Hall
Again, in some of your wealthier countries they were able to actually produce and make vaccines faster than other countries and and again that that really is something that can affect.
00:58:02 Heather Hall
Everybody, because especially with COVID.
00:58:05 Heather Hall
You know one population may be more well vaccinated against it, while another population might not be as well vaccinated and in that population.
00:58:16 Heather Hall
That's not as well vaccinated.
00:58:17 Heather Hall
There's going to be more potential for more variants of and mutations of COVID to develop, which then could potentially.
00:58:26 Heather Hall
You know, not be responsive to the vaccines, you know that are more heavily accepted or or available in this other population.
00:58:34 Heather Hall
So again, it's it's it's kind of we're all in this together and COVID was really a great example of how.
00:58:40 Heather Hall
Uhm, you know that access to health care services really is important to look at.
00:58:49 Heather Hall
On a global scale, not just.
00:58:50 Heather Hall
Uh country to country but but but it we you know again with with transportation and the connectedness of everybody.
00:58:57 Heather Hall
Nowadays one thing happening in one country can.
00:59:01 Heather Hall
Really affect the health and well-being of somebody in another country.
00:59:06 Heather Hall
And just a little bit more about affordability.
00:59:09 Heather Hall
Of of health care in 2000 and 2158% of adults worldwide. Agreed that many people in their country couldn't even afford good healthcare, so so that goes beyond.
00:59:21 Heather Hall
An issue of access that goes.
00:59:23 Heather Hall
You know you may have access to something, but you you can't.
00:59:25 Heather Hall
Actually afford it?
00:59:28 Heather Hall
So that's that's.
00:59:30 Heather Hall
A huge factor at play and really impacts how people utilize healthcare. I've even seen in just a couple examples I've seen in an African hospital where you know the patients weren't allowed to leave the hospital until they paid 70. At least 70% of their bill. And as you can imagine, that.
00:59:51 Heather Hall
That creates a really interesting situation, because, OK, if I.
00:59:55 Heather Hall
Can't leave the hospital to.
00:59:56 Heather Hall
Work, how am I going to pay my bill?
00:59:59 Heather Hall
You know, and this wasn't something that was done as a punishment or anything like that.
01:00:04 Heather Hall
It was more just a kind of.
01:00:05 Heather Hall
A reality of.
01:00:06 Heather Hall
Like OK, we we have to hold people accountable.
01:00:10 Heather Hall
To paying for the care that they're receiving.
01:00:11 Heather Hall
Otherwise you know the hospital is going to go under and then no one going to receive care, and so then you had to have family members try to find work to actually pay for these bills and those family members.
01:00:24 Heather Hall
You know the majority of them may have been children or or a wife, and they you know aren't maybe used to working.
01:00:30 Heather Hall
Or don't have the ability to work so it can be some really complicated situations that arise by not being able to pay for health care.
01:00:40 Heather Hall
And again, this is not.
01:00:41 Heather Hall
Something that's limited to other places around the world.
01:00:43 Heather Hall
This is not that US versus them.
01:00:45 Heather Hall
You know this is something that very much happens here in the United States and I think we all we all probably know that and have our own personal.
01:00:52 Heather Hall
Experiences or exposure to that.
01:00:55 Heather Hall
01:00:58 Heather Hall
But yeah, so that again does the affordability is really something important to to keep note of and and again the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths compared to other high income countries. You know EU.
Sorry, I'm going to have to.
01:01:17 Heather Hall
Restate that one.
01:01:19 Heather Hall
So again, you know affordability is not something that's limited to other places around the world.
01:01:24 Heather Hall
It's not an issue that's just in other places around the world. the US actually spends more than any other country in the world on health care that actually has the lowest life expectancy. The highest burden of chronic disease.
01:01:36 Heather Hall
The highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths compared to other high income countries.
01:01:43 Heather Hall
So again, it's not just an issue of, it's not just an issue in maybe a low resource country, but you know, affordability of health care is is an issue that really affects everyone.
01:01:56 Heather Hall
Another challenge that's often faced in global health is a lack of trained health care workers.
01:02:01 Heather Hall
So again, kind of touching back on that maternal maternal health topic.
01:02:07 Heather Hall
You know you're you're having women who are delivering in very remote areas, and oftentimes they don't have.
01:02:16 Heather Hall
Access to to health care they don't have access to a nurse and nurse midwife clinic.
01:02:21 Heather Hall
Things like that and oftentimes you'll.
01:02:26 Heather Hall
You know, some communities have tried to address this by.
01:02:29 Heather Hall
I mean having what they called traditional birth attendants or skilled birth attendance to try to provide at least a little bit more higher level of care in these communities to to help combat this challenge.
Yeah yeah, thank you, Heather.
The the lack of trained health care workers is a really big issue, and we'll talk in a minute about some of the strategies they use to.
Tackle that, but what we see in a lot of countries around the world is that they.
Have less than one.
Doctor per even 100,000 people, and so there's very little access to getting.
Another big issue that we see is not just having access to healthcare, but having access to preventative services and screening and then on the foot on the other end of that, having access to advanced treatment of diseases so.
In Sierra Leone, for example, we are looking to begin.
A program on.
Breast cancer screening and cervical cancer screening in Sierra Leone.
But then the question with that is, you know once we screen for these.
Diseases once we have the ability.
To detect and and.
Take and detect and and know and diagnose these diseases.
Will a patient be able to have the ability to get treatment for them?
If a you know if you find out that you have a breast cancer diagnosis, well, how far away is the nearest Health Center that can provide you know?
Uh, mastectomy or chemotherapy radiation?
So the the benefit of having.
You know these what we call like early public health measures of prevention.
Things like that are only helpful if you can build it on the other side as well and have the the access to advanced.
Treatment of diseases.
And and that also really ties in well with the integration of health delivery, which is another really big issue we see in the global sphere.
So you know, having a a clinic.
That's nearby a patient.
You know, a person lives within a mile walk, perhaps of a.
Of a health.
Clinic and they have trained health care workers there.
Well that's great, but if this trained health care worker recognizes you know this person has a hernia.
This person has cancer.
They can diagnose this advanced disease, but how are they doing that?
Referral to this to a clinic that can do the treatment.
You know, are they able to have a contact with a hospital with a, you know, an advanced treatment center that can carry out this.
This helped delivery and the same thing with like we see in maternal and child health.
You know we can have a health clinic that does antenatal clinic visits, you know and and can take care of a patient before birth.
But then are they able to help the mother when she is in labor?
If she had, you know, a hemorrhage.
Would they be able to help her?
And if not, would they be able to refer her to a place and get her there in time to take care of her before you know she bleeds out?
So this integration of health delivery, which is.
Why you know in Sierra Leone?
Mercy Hospital has linkages with.
Clinics when we do outreach.
We particularly do it.
At areas that already.
Have a health clinic to improve this integration of health delivery.
01:06:05 Heather Hall
Yeah, integration of health delivery I think ties in well next to our the next challenge which.
01:06:13 Heather Hall
That cultural and language barriers you know to program.
01:06:17 Heather Hall
So if you have if you have.
01:06:19 Heather Hall
Resources in a community that are not major.
01:06:21 Heather Hall
Maybe culturally sensitive or have a more accessible to to those who maybe speak a different language than you know the the primary language of the country.
01:06:31 Heather Hall
You know, there can be a really significant.
01:06:33 Heather Hall
Impact on people's ability to to access health care and a couple. A couple example real life examples that I can.
01:06:40 Heather Hall
Kind of, you know, have to do with.
01:06:45 Heather Hall
You know when I've done some of the.
01:06:46 Heather Hall
The COVID work.
01:06:48 Heather Hall
You know and and people are making phone calls to to figure out what to do about COVID.
01:06:53 Heather Hall
You know either they've been exposed or they have COVID you know the importance of having an interpreter.
01:06:58 Heather Hall
Who can actually talk to them and you know and give them the appropriate information they need because there there are times, especially if you have languages that are are much less common in the in the country.
01:07:10 Heather Hall
You know they're not.
01:07:12 Heather Hall
That person might not be able to just go on a website and navigate the website to find the information they need, because the information might be in a totally different language.
01:07:20 Heather Hall
And so that I can really.
01:07:21 Heather Hall
Be a barrier to to.
01:07:23 Heather Hall
Care that people have one other example of this that I think of is when I worked with the refugee program in Ohio so we would have refugees that would come from all different countries and they would come to us at the Health Department to have their initial health screening.
01:07:38 Heather Hall
And then we would also set them up.
01:07:40 Heather Hall
With referral to a primary care clinic, but on numerous occasions we would have.
01:07:45 Heather Hall
We would have patients that would come back to the Health Department because they knew they could get help there specifically with an interpreter because there were other issues that they were having at some of the other places where they.
01:07:58 Heather Hall
Were trying to.
01:07:58 Heather Hall
Get care where they they, maybe didn't have.
01:08:01 Heather Hall
Uhm, you know adequate access to interpreters, or at least fast enough. Access to interpreters. And it really did create a barrier, and so a lot of times we would have have clients that would come back to the health department and we would have to just help them set-up appointments, not even getting care there at the health department, but getting care elsewhere.
01:08:22 Heather Hall
Yeah, so you can really go on and on about cultural language barriers.
01:08:26 Heather Hall
That's that's really a huge topic in and of itself and and you know, one of the one of the foundational things about is trust.
01:08:33 Heather Hall
You know, people have to be able to.
01:08:35 Heather Hall
Trust who they're getting care from.
Yeah, yeah, I'm I'm so glad you.
Brought that up, uhm?
Heather the the the cultural.
Issues and we'll talk about a little bit more about some strategies to tackle that, but trust in a community is a huge issue within the realm of global health, and in fact we work with the Christian connections for international health and they do a lot of work on how.
Faith and health are interconnect.
And one of the areas that they're looking into right now is the engagement of faith leaders in immunization.
So a lot of communities around the world are very religious.
They have a pastor, a preacher and Imam a rabbi, A leader whom they trust and believe in, and engaging faith leaders.
In a way.
Building that trust between a community and A and the health field is a huge area where they've been working engaging faith leaders and teaching about immunization, especially around COVID.
19 in you know health care utilization which we talked about earlier going to a clinic when you are sick.
Knowing some of the warning signs of things because trust is such a big barrier, and of course with trust you have the issue of fake news.
You know there's a lot of information and misinformation that's being spread.
Said about diseases, about how they're spread about, how to treat them and this, you know, it's something that we talk about a lot with COVID-19 and diseases like COVID-19. But even before COVID
We saw issues like this with other vaccinations.
It's a big reason for vaccine hesitancy, in fact.
I I spoke with a researcher from.
The from George Washington University and prior to COVID-19 he did a lot of research on why where vaccine misinformation comes from.
Where do people learn?
You know this information about vaccines you know?
They did this.
Condition or lead to that condition or not.
He traced it back to terrorist groups.
Organizations like ISIS and Al Qaeda are spreading this information on their website, and then it gets filtered down, you know, through different other sites and eventually ends up somewhere on Facebook or Twitter and people will.
But and so bridging that gap of building trust and combating misinformation is a huge barrier to.
Global health worldwide
01:11:15 Heather Hall
Yeah, that you bringing up that story really reminds me of something that was kind of a light bulb moment for me in in public health is is learning the the difference between relief, rehabilitation and development and you know.
01:11:31 Heather Hall
So if you're having an issue.
01:11:33 Heather Hall
01:11:34 Heather Hall
Incorrect information being shared.
01:11:36 Heather Hall
You know it's going to be really important to know what type of intervention you're you're to know you know, know the situation to know the appropriate intervention to combat that issue, you know.
01:11:50 Heather Hall
So, for example, if you're having.
01:11:51 Heather Hall
An issue with.
01:11:53 Heather Hall
01:11:54 Heather Hall
Distrust and misinformation about vaccines, you know.
01:11:58 Heather Hall
But you see that these people need vaccines.
01:12:00 Heather Hall
You know the first step maybe isn't to just go in and try to administer vaccines.
01:12:04 Heather Hall
Maybe a first step is actually trying to address questions and you know actually have conversations with people better understand.
01:12:11 Heather Hall
And the hesitations, and the fears and concerns, which are totally justified.
01:12:16 Heather Hall
And you know, again, you have to figure out.
01:12:19 Heather Hall
OK, where are where are people?
01:12:21 Heather Hall
Where are communities in terms of of of what stage they're in?
01:12:27 Heather Hall
Are they in a state of relief meeting, relief efforts, rehabilitation?
01:12:31 Heather Hall
Efforts or development and I won't go into that too much here.
01:12:35 Heather Hall
'cause we'll probably touch on it in a little bit, but but yeah, that that's one thing that I found really, really helpful when looking at the challenges that a community is facing, but then also trying to figure out what interventions should be put in place.
Yeah, I I'd sound like a broken record.
Now I think the the difference between you know development you know is is this country in a or this community in the stage of development?
Do they need immediate relief?
You know humanitarian work after a disaster or rehabilitation is probably something we could do.
A whole other podcast episode on, but yes, depending on the context that a population is in will determine what interventions are used and apply.
And Heather, I wonder if we could talk a little bit about some of the interventions that we know have been proven to be effective in combating disease we've we've touched on a few of them.
You know, as we we talked about each of the diseases.
But you know, there's there's a few big topics in this that I think would be useful to.
01:13:42 Heather Hall
Yeah, sure so to.
01:13:44 Heather Hall
To build on the importance of understanding the stages of where a community is in terms of relief, rehabilitation or development.
01:13:51 Heather Hall
One thing that's really important in in assessing that is participation by the community.
01:13:58 Heather Hall
You know it's it's really vital to have that community input.
01:14:03 Heather Hall
You know these are other people community you know.
01:14:05 Heather Hall
Especially if you're maybe.
01:14:07 Heather Hall
Living in one country, traveling to another country and trying to to do some kind of work.
01:14:12 Heather Hall
It's really important that you come in with a, uh, learners mentality.
01:14:16 Heather Hall
You know you come in with humility and you come in to try to learn and learn from the people that are that are living there that are having the issues that are living those issues out day-to-day because they are the experts.
01:14:27 Heather Hall
In their community.
01:14:29 Heather Hall
They have invaluable insight and expertise into the many factors that make up and.
01:14:33 Heather Hall
Affect their community?
01:14:35 Heather Hall
And that's going to be information that you know you as the you know, outsider.
01:14:41 Heather Hall
You'll never be able to have and and.
01:14:44 Heather Hall
Therefore, their their insight is going to be.
01:14:48 Heather Hall
Uhm, you know can can really be beneficial and largely impactful in in what interventions are applied in how they're applied.
01:14:57 Heather Hall
So some of the most important interventions using global health again, which help us make progress toward those sustainment develop sustainable development goals, especially #3, which is good health and well-being.
01:15:08 Heather Hall
Some of those interventions are kind of.
01:15:12 Heather Hall
You can maybe even sum them up in 2 main categories.
01:15:15 Heather Hall
Prevention and education.
01:15:17 Heather Hall
Which can also be called health promotion and then also diagnosis and treatment.
01:15:22 Heather Hall
So to break down prevention and education a little bit interventions related to prevention are some of the most important because they can really prevent premature deaths and help stop or minimize the impact of diseases.
01:15:36 Heather Hall
Which, again, if not prevented, can affect many other.
01:15:40 Heather Hall
Areas of people, people.
01:15:41 Heather Hall
Lives kind of that domino effect.
01:15:43 Heather Hall
If you will, and as we said before, the Sustainable development goals are all interconnected and impact in one area can really affect the outcome in another.
01:15:53 Heather Hall
So for example, if you have a parent who has a child that is sick from a preventable disease, whether it's preventable through hand washing or vaccination, that parent may end up having to miss out on work or spend a lot of money to care for the child.
01:16:07 Heather Hall
And if your family is already impoverished or on the brink of poverty and illness, and one family member.
01:16:13 Heather Hall
Can cause major implications for the well-being of the entire family, which for many families is how they end up being stuck in a cycle of.
01:16:20 Heather Hall
Poverty, so again, if you can implement some of those preventative measures that help prevent families from going over that Brink, going into poverty or you know worsening the poverty, those interventions preventative interventions can be really impactful and really help move.
01:16:41 Heather Hall
Move people closer towards that.
01:16:42 Heather Hall
Goal of good health and well-being.
01:16:44 Heather Hall
Other types of prevention strategies you know, a lot of people probably already know our strategies, like screening.
01:16:50 Heather Hall
You know whether that's a mammogram?
01:16:52 Heather Hall
Cervical cancer screening.
01:16:54 Heather Hall
Obviously, vaccinations are are very well known and then also antenatal care is another type of preventative strategy.
01:17:02 Heather Hall
So I won't I won't.
01:17:04 Heather Hall
Dwell on that too much 'cause a lot of people are familiar with types of preventative strategies.
01:17:11 Heather Hall
I'm now moving on to education a little bit.
01:17:13 Heather Hall
Again, we all know how important education is.
01:17:16 Heather Hall
Education is something that can be shared freely and easily with one another and can empower people to take responsibility for their health in ways that only they can do.
01:17:25 Heather Hall
Which is probably one of my favorite things about education and why.
01:17:29 Heather Hall
I really enjoy education.
01:17:31 Heather Hall
Is that again it can empower people to to do something themselves.
01:17:35 Heather Hall
You know something that only they can do, that I can't do for them.
01:17:40 Heather Hall
Especially in some global contexts where access to mental medical treatment is limited.
01:17:44 Heather Hall
Education, especially when education is used.
01:17:49 Heather Hall
Through community engagement can.
01:17:52 Heather Hall
Really be a strong way to prevent diseases and promote health, and again can be very impactful in encouraging things like health seeking behaviors.
01:18:01 Heather Hall
One example from the field that I can think of was when I was again a part of that Community health and development program in Kenya, where one of the aspects of the school wash program was that schools had to have a hand washing station and then kids were taught how to wash their.
01:18:17 Heather Hall
Hands now if you know kids they often.
01:18:20 Heather Hall
Like to show off.
01:18:21 Heather Hall
New things they learn, and one of the thoughts was that you know kids would not only learn how to wash their hands, but then they would actually go home.
01:18:29 Heather Hall
And teach their families the same behavior and they would also end up being advocates for creating hand washing stations at their homes so they could wash their hands at home the same way they were at school, and so by engaging the kids and educating them in this health seeking behavior, washing hands, you know we have the opportunity to.
01:18:50 Heather Hall
Impact many more households and spread.
01:18:52 Heather Hall
You know this information much further in a way that otherwise would take much longer.
01:18:58 Heather Hall
It you know, if one community health worker had to do it all individually.
01:19:02 Heather Hall
And you know, Speaking of community health workers Yasmin, I know you were going to touch on that a little.
01:19:07 Heather Hall
Bit and so I thought.
01:19:09 Heather Hall
If you'd want to, maybe chat on community health workers a little bit before we talk about diagnosis and treatment.
Yeah, yeah, I'd love to.
I do want to circle back to what you're saying about hand washing stations historically.
In the field.
Of public health training children you know, educating children on good health practices.
Has been a major.
Strategy for getting people all across a country to engage in health seeking behavior.
We see this with seat belt campaigns.
Children were taught, you know, you're supposed to.
Wear your seat belt.
In your car and then you.
Know Mom picks them up.
In carpool and they say, you know, Mommy, why aren't you wearing your seat belt?
You're putting me in danger, and that would be it. Just it has major implications and is is a very effective strategy in the 1900s actually, you know, we see in the early 1900s.
Almost nobody is washing their hands.
Almost nobody is, you know, wearing shoes outside and you know, engaging in these safe hand washing practices, and we in the United States did hygiene campaigns in schools, some big names companies would go into schools.
And do these.
Plays about washing your hands and cleaning your food and washing your vegetables, and then children would take these interventions home.
And teach their.
Parents about it.
So that's just a really cool.
Way that public health has been operating over.
The last years.
But yeah, community health workers.
Community health workers are one of my favorite topics in public health and in global health especially, I watched Ted talk about it when I was a senior in college and that really awokened me.
This desire to work in public health because.
I thought that this was the coolest.
The coolest way to to start tackling health care worldwide.
So one of the main ways that Healthcare is advancing globally is through the use of.
Community health workers
The Ted talk that I'm talking about is called investing in healthcare workers strengthens communities, but the the essential topic of this is that a community health.
Worker is a layperson who is a trusted member.
Of their community.
This person is usually given training on disease recognition and treatment and then they are able to use that trusted relationship they have with the community to link between the people in that community and healthcare services so they can give treatment for basic conditions.
So you know, recognizing malaria, giving malaria medication.
But they also can refer people.
For treatment for serious disease conditions.
And and most of all, a lot of community health workers work in this area of education.
So educating communities on prevention on disease, recognition on building health, seeking behavior so you know, this, really.
This strategy is one that really helps with some of those issues we were talking about earlier, such as the integration of health delivery, bridging those cultural and language barriers to getting into a community because you select someone in a Community that has already has the trust of the of the people there.
01:22:26 Heather Hall
Yeah, I kind of wanted to touch touch again on.
01:22:32 Heather Hall
You know the cultural and language barriers.
01:22:35 Heather Hall
Like community OK sorry are you done then you want me to go ahead and move on.
01:22:40 Heather Hall
To diagnosis and treatment.
01:22:41 Heather Hall
OK sorry, OK yeah, so just to touch on really quickly about diagnosis and treatment.
01:22:48 Heather Hall
You know I don't want to spend a lot of time here.
01:22:50 Heather Hall
01:22:50 Heather Hall
Know we've covered so much.
01:22:51 Heather Hall
Already, you know, and diagnosis and treatment it is.
01:22:55 Heather Hall
Pretty self-explanatory, but again.
01:22:56 Heather Hall
And one thing to remember with global health is that diagnosis and treatment may look very different in one country compared to another, so they're mirror again, like we've kind of touched on before.
01:23:08 Heather Hall
There may be varying levels of ability between countries to diagnose and treat something, and you know the wealthier again the wealthier country does not.
01:23:16 Heather Hall
Always mean that they are better able to diagnose or treat something.
01:23:21 Heather Hall
You know one example that I always think of is malaria.
01:23:25 Heather Hall
You know malaria may be heavily present in one country, while it may not be an issue at all in another country.
01:23:32 Heather Hall
And you know, I've heard I've heard stories of of people, even some personal contacts, who you know they've been traveling overseas, came back.
01:23:40 Heather Hall
To the United States got.
01:23:42 Heather Hall
Sick you know?
01:23:43 Heather Hall
And it took their.
Their doctor, quite a.
01:23:45 Heather Hall
While to figure out what what they had.
01:23:47 Heather Hall
You know it wasn't.
01:23:48 Heather Hall
A first thought for the provider to.
01:23:51 Heather Hall
To test for malaria and then once they did test and found out.
01:23:55 Heather Hall
But it was, you know, they had to to reach out for a special consultation to even know how to treat it.
01:24:01 Heather Hall
And and you know, like Yazmin had talked about earlier, you know there's the total opposite end of that.
01:24:07 Heather Hall
You know the flip side.
01:24:08 Heather Hall
You know you're maybe looking at some other countries that are under resourced and they may have.
01:24:14 Heather Hall
They may struggle more with treating some of those chronic diseases such as diabetes, because again, maybe those health care.
01:24:21 Heather Hall
Providers haven't had to learn how to deal with that because that hasn't been as present in the population.
01:24:27 Heather Hall
But again, now as we're going through this, this change, you know, some of these providers are having to deal with it more and therefore are having to to try to figure out how do they actually address that.
01:24:39 Heather Hall
And you know, it's not necessarily even just a an issue.
01:24:42 Heather Hall
With with the.
01:24:43 Heather Hall
Health care provider.
01:24:44 Heather Hall
You know it's it's maybe even an issue of the patient dealing with their own.
01:24:48 Heather Hall
Health issue their own chronic disease you know such as diabetes.
01:24:51 Heather Hall
You know, if you're somebody who has diabetes and you need to be on insulin, you're going to need to have a refrigerator.
01:24:58 Heather Hall
Depending on you know how your treatment is going and so are you in a in a place where you have a refrigerator that you have access to where you can store your medication or you do.
01:25:07 Heather Hall
Or do you have access to more foods that.
01:25:11 Heather Hall
You know that aren't as starchy, or that will raise your blood sugar as much so.
01:25:16 Heather Hall
Yeah, so that that really comes into play with diagnosis and treatment.
01:25:20 Heather Hall
You know the the again the environment that you're living in, the healthcare infrastructure.
01:25:25 Heather Hall
All of those can really impact.
01:25:27 Heather Hall
Uhm, you know diagnosis and treatment again, not only.
01:25:31 Heather Hall
For the health care.
01:25:32 Heather Hall
Provider but again also for the patient.
Thank you Heather, for for bringing up.
01:25:36 Yasmine Vaughan
The the flip side of that.
And the the linkage between malaria in the United States and its linkage.
To other places and.
The ability to diagnose and treat being unequally distributed.
And you know to harken back we were talking about earlier about the interconnectedness.
Of the Sustainable development goals.
We see with climate change.
That this is a massive problem as we see in the United States, especially West Nile virus, West Nile virus being more common and more prevalent in places like Florida and the southern parts of the United States.
Because of the changing climate and having providers that have the ability to diagnose these conditions, even though.
They're sort of.
New so to speak to the area like we were saying before.
Health global health is.
We should have had a bet on how many times we are going to say interconnectedness, but these things are all connected and looking at global health from this global perspective is is really important.
I think you know to wrap.
Up as we've seen in today's episode, the health issues faced.
In one part.
Of the world, massive impacts on other parts of the.
World we've seen in the last few years.
An emerging disease in China.
Has the ability to impact everyone everywhere and we know that these issues in International Development like climate change, poverty, clean water are also connected to health and these are all impacted by social systems and by health systems.
You know it helping children worldwide.
We care about health issues.
All around the world.
And we seek.
For everybody, so I hope you've enjoyed this overview.
If you were still there, listening with us of what is global health this, like I said before, this mile wide and inch deep overview of the topic and.
Heather, thank you.
So much for sharing your knowledge and your experience with us.
We hope to have you on the episode or on the podcast.
Do another episode again one day.
01:27:30 Heather Hall
Yeah great, thanks so much.
01:27:31 Heather Hall
I've had such a good time.
01:27:33 Heather Hall
I love talking about global health and public health and it's been a joy.
01:27:37 Heather Hall
Right, thank you, thank you.
To learn how you can get involved in the work of helping children worldwide in global health, go to helpingchildrenworldwide.org global health.
01:28:05 Speaker 5
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